Study on Hot Flashes, Heart Attacks Raises Additional Questions

Several months ago, my friend and massage therapist Ruth emailed me with an idea: perhaps hot flashes, while being uncomfortable, might provide women with extra protection from major illness. I thought Ruth’s question was interesting, but hadn’t seen any research that would support Ruth’s theory – until recently.

A study published recently in the journal Menopause found that the timing of hot flashes may be linked to heart attacks. Researchers from Harvard’s Brigham and Women’s Hospital and Northwestern University’s Medical School studied more than 60,000 women, ages 50 to 79, for an average of a decade. Their analysis found that women who had hot flashes at the start of menopause but not later had a lower risk for heart attack and death than women who had never had hot flashes. They also had a lower risk of heart attacks than women whose symptoms continued long after menopause began.

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“Researchers found that women who had their worst hot flashes and night sweats around the time menopause started had a 17 percent lower rate of stroke and an 11 percent lower rate of heart-related health problems during a followup period of nearly 10 years than women who had no initial symptoms,” U.S. News and World Report reporter Angela Haupt wrote. “Heart attack and deaths from any cause also were lower, by 24 percent and 22 percent respectively.” The study also found that women who developed hot flashes later in this transition (and in some instances many years after menopause started) had more heart attacks and deaths than women in the other groups that researchers studied. Haupt stated, “Why early symptoms are associated with fewer cardiovascular events is unclear, the researchers said, but they noted that hot flashes that occur well after menopause may indicate instability in the blood vessels.”

Although this is really informative research, I find that I want additional details. As a layperson, I would like to know the researchers’ definition and the timeline for the start of menopause. Based on various sources, menopause can be broken down into different stages. For instance, in “The No-Nonsense Guide to Menopause” authors Barbara Seaman and Laura Eldridge describe perimenopause as “the supposed ‘beginning’ of menopause.” They added, “We believe that in the same way women use ‘menopause’ colloquially to mean the whole process, they use ‘perimenopause’ not to mean the entire time before the actual menopause but rather the first moments or months or years when a woman understands that her body is changing.” Dr. Holly L. Thacker defines perimenopause in her book, “The Cleveland Clinic Guide to Menopause,” as follows: “During this period, ovarian function becomes erratic. A woman may detect physical signs, such as hot flashes and irregular periods. Perimenopause usually begins sometime in a woman’s 40s and lasts a full year after the final menstrual period.” She also defines menopause as “the time when the ovaries stop releasing eggs and a woman no longer has periods. Menopause usually occurs between the ages of 45 and 55. A general indication of menopause is cessation of periods for twelve consecutive months. The average age for women to experience menopause in this country is 51.3 years.”

Therefore, my confusion with this study is based on whether the researchers are describing menopause in the colloquial way that Seaman and Eldridge noted, or whether they are using a definition that is more closely aligned with Thacker’s information. Their clarification would help all of us better understand any beneficial benefits and risks of hot flashes based on when they occurred in our own unique medical history.